I had the Intralase LASIK procedure a little over a week ago (4.4.07). My right eye has progressed wonderfully (20/20), however a day post-op, my left eye became extremely inflammed and began worsening over a 48 hour period. I was told that I had either infection or inflammation in my left eye and began to see what appeared to be clouds on my cornea (DLK and/or infiltrates). It was so bad by 4.7.07 (3 days post-op) that my eye lid was swollen and I was in pain where I could not sleep or function normally....felt like stinging in my eye. I have been going daily to the doctor and corneal specialist to treat what they now say is inflammation and/or DLK in my left eye. By today (4.14.07), I do not feel pain, the DLK seems better (or so I was told), however my vision seems foggy and worse in my left eye as well as a feeling of irritation still remains in that eye (like a piece of sand or something...at times it feels better and at times worse). I am on Pred Forte every hour at least until 4.16.07 and taking oral meds (Med Pack, Doxycycline) and Vigamox 3 times daily as well as Maxitrol ointment at night. Unfortunately, I am becoming more negative as the days go by and losing hope. I feel that even though the docs are saying it is clearing up little by little, that maybe my cornea will sustain long term damage and/or my vision will not be very good in the end. Is there hope? Please advise. Should I seek a second opinion? Thanks.

Diffuse Lamellar Keratitis (DLK) is an unpredictable complication related with sterile infiltrates getting under the Lasik flap. Even though they are sterile, the cornea attacks them and causes all sorts of problems. DLK is scary to the patient because of rapid onset of pain and vision loss.

It appears your doctors are applying an aggressive regimen of treatment and observation. This is exactly what needs to be done. You mention that you are seeing a corneal specialist. That is very good as these tend to be the people who know best how to treat such matters.

DLK can take a little while before the inflammation goes down and vision begins to clear. It is possible for symptoms to be long lasting, but the rapid and aggressive treatment you are receiving would make that probability relatively low.

If the DLK symptoms persist, you may have a problem that appears similar to DLK but is actually something different. Your doctors may recommend lifting the Lasik flap, taking a sample of the area for lab analysis, removing infiltrates, flushing the area, and then repositioning the Lasik flap. The lab results will tell if the problem is actually something other than DLK and treatment should be altered.

There is nothing wrong with being worried – your eyes are under attack from within – but you are getting treatment for a problem that is well documented and reasonably well understood. The probability of a good outcome is relatively high. Keep your doctors informed of any changes, treat your eyes exactly as instructed by your doctors, and expect the best.

If the DLK does not respond to treatment, your current doctors may refer you to a sub-specialist for care.

I appreciate the information and it gives me hope and makes me more positive. Any idea on how long it typically takes for DLK (corneal infiltrates) to clear up after treatment??? I am curious since I still have some and it seems to be taking a while (a week so far). Is this a condition that takes weeks and/or months of treatment to clear up fully? I have done my research and have yet to get a good understanding of the time it takes to treat etc. Thank you.

The time necessary for recovery is so individual that it would be difficult to predict. It sounds like you had a pretty bad event and it may take a while for the cornea to settle down and clear. That may be weeks, however your surgeon will be better able to predict. You will undoubtely have reasonably good vision long before the cornea is perfectly clear, so function will return before the healing process has completed.